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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT Date: N Owner: Address Builder Address IANWWWW LO TIN OF BU LDING NO..� Sheet l0part o T.ot �dition or Sub-DiVU.9 ..r. Corner Lot .__ Inside Lot Y.. Setback .�� Side d _._..�'._. Sewer Elevation _ _ __ _ Foundation Elevation DESCRIPTION OF BUILDING To Used ast A Front Depth Height Sq. Ft. = cu. Ft p+'+ --� � Depth �-� �. Ft Cu. Ft Type of Construction �� Est. Cost To be Completed — In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set forth and in compliance . with all provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of .$ , permit is hereby granted to to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon of any of the provisions of said ordinances. .On A,002 � NOTICE: This permit does not cover the construction, installation for whing, plumliing, gas heating, sower or water. Be sure to see the Building Inspector for separate permits for these Items. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owner's Name `z-.� 9 Builder Address p 9 /� d����� �- Address LOCATION OF BUILDING No. P Street S 7 Z�e(--R?6-e-j2,e�,e,,go Part of Lot _ _ c Lots a 1 Block__�_Addition or Subdivision C9 r - Corner Lot Inside Lot Setback ;T -1 t5 6 Side -Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To be used as:I Front Depth —Height J-40 Sq. Ftv �Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. --- low- Type o - Type of Construction Estimated Cost � - To be Completed The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strictaccordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE % aje 76 -) SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). APPROVn stjaJ.tcT TO COMRwd. °0 OPLICAB d IT, TI CITY ?] U11MESOTA 40 64 City of Fridley Application for Plumbing and Gas Fitting Perndt DepL of Bldgs. Phone SII 4-7470 DESCRIPTION OF WORK Number, Kind and Location of Fixtures i +' 3d 7 �� 0x �iT�jOZ m 3� o� u� O(�o tTfz�_ t� O <3 J (�9°d �U' 4a 0 Z (�y0 • F • N WATER HTR. GAS ELEC. Base x 3.25 $ GAS FITTING FEES: 1st 3 Fixtures ..........................3 Additional Fixtures .................... Gas Range to 200,000 BTU .............. NO. x lo;--- x x RATE TOTAL S $1.50$ T . 0 .50 $ j5— 2.00 It �T• �� 1st 2nd 3rd 4th • Future Connection Openings I New Fixture, Old Openings Connected with Sewer E] Cesspool ❑ PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: TOTAL Number Fixtures ...................... 0x $1.50 $ Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ Water Heater (Up to 200,000 BTU) ......T x 3.25 2.00 $ $ ;C `® x New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: 1st 3 Fixtures ..........................3 Additional Fixtures .................... Gas Range to 200,000 BTU .............. NO. x lo;--- x x RATE TOTAL S $1.50$ T . 0 .50 $ j5— 2.00 It �T• �� REPAIRS & ALTERATIONS—Refer to Code Description ................................................ TOTAL FEE City of Fridley: V1 The undersigned hereby .makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this app tion a true and correct. /1 Fridlev. Minn_ Owner Kind of Buil g Used as To be completed about Estimated Cost, $ 'Z LO v L., Old New uilding Permit No Permit No. Signe By Business Phone ROUGH 9 / 6 e, z_ FINAL q-6 . 6 z.� 42 2M, Application for Power Plants and Heating. Cooling, Ventilation. Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work ........................... 8.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ each add. 60,000 BTU ....................... 2.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 ................. 5.00 $ Repairs & Alterations each add. $500.00 .............. 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ..... 8.00 $— Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ..8.00 $ a Each add. 200 sq. ft. EDR.Steam ...................... 2.50 $— ado _ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ --" OIL BURNER—to 3 gal. per hour ........................ 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ 2) GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $ Additional Fixtures ................ x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM g� ALTERATIONS & REPAIRS TOTAL FEE $ ROUGH FINAL Dept. of Bldgs. Phone SU 4-7470 -5-7 - ��-4_t & City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the. City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, Minn Owner Kind of Used as To be completed about -12 Estimated Cost, $ rz-,75� Old—New. Building Permit No. ® Permit No. .X -e-, DESCRIPTION —C - DESCRIPTION OF WORE HEATING or POWER PLANTS -Steam, 0of Water, arm Air—No Trade Name Size No- :z/o, o Capacity 9 i " Sq. Ft. E.D.R "'40BTU H.P. Total Connected Load—�400� � Kind of Fuel BURNER —Trade Name- Size No Capacity Sq. Ft. E.D (REMARKS—OVER) BTU H.P. Signe By FFE ../Vec[tin � e�ice [19f6 511 W. 7th ST. CA. 7-7573 - ST. PAUL -2, 2M Business Phone No City of Fridley, Minn. N° 7755 • BUILDING PERMIT Date: June 7, 1965 • per: Dr. Herman Builder Metro Builders,, Inc. Address 266 .-57th Place N. E. Adm 2909 Ni collet Ave. LOCATION OF BUILDING No. 262 street 57th Place N. E• Part of Lot Lot 3--5 Block 7 Addition or Sub -Division City View Corner Lot _ Inside Lot Setback Sideyard Sewer Elevation _ Foundation Elevation To be Used as: Front Front Type of Construction DESCRIPTION OF BUILDING Storm damage repair Depth Height Sq. Ft Depth Height Sq. Ft — Est. Cost — 3s 6QQc� To be Completed cu. Ft Cu. Ft In consideration of the issuance to me of a permit to construct t1ifebuilding described above I agree to do the proposed work in accordance with the description above set fo � ce with afl provisions of ordinances of the city of Fridley. Ea consideration of the payment of a fee of $ 20.00 , permit is hereby granted to Metro Builders s Inc. to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any pari thereof, shall conform in all respects to the ordinances of Fridley, Minnesota location, constructt��Ion, alteration, maintenance, repair and moving of buildings within city limits and permit may be revoked at any time upon violation of any of the provisions of said Allen Jensen Building Inspector NOTICI« 71218 p4n dt does not sever the condrudion, hutalidion for Wiring, phrmbi ng, on heating, sewer or water. Be wro to no the Building hupe8ter for sopmte perdu for these hens. LOCATION OF`BUILDING NoStreet 571" Part of Lot LO'L BLOCK Z ADDITION OR SUBDIVISION =�ra Corner Lot inside LOT Setback. -Side-Yard SEWER ELEVATION' .FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. To be used as; DESCRIPTION OF BUILDING Front Depth Height Sq. Ft. Cu. Ft. Front Depth Height, N, _Estimated Cost 1 To -be •u f i v The undersigned hereby makes application for a permit -for the work herein specified, agreeing to'do all.work in strict accordance with the City of Fridley Ordinances and rulings of the Departmeot'of:Buildings,:and.hereby declares that all the facts and representations ted in this application are true and correct. DATE SIGNATURE (Schedule of Fee Costs can be found -,on the•Reverse Side) IS-14 %ado F: C CITY OF FRIDLEY 5431 UNIVERSITY AVENUE N.E., FRIDLEY, :MINNESOTA 55432 Ak. Faut Ruud Anoka County Engineer ANOKA COUNTY COURTHOUSE 325 E. Main SUeet Anoka, MN 55303 TELEPHONE ( 512)5713450 September 17th, 1976 eIQ— VAa mage Pnobtem ,ton County Road 0102 and 3rd Stireet NE ; Deas. Paut: hose been bnoug to oul. attention by the pnopenty ownex 262 -57th Avenue that a drai nage pnobtem ex Tata &nom the c enc wing a Bong the north z i.de o6 County Road #102 (57th. Avenue). It appeau the water pnoceed6 around the nonthweat connen and into the app tment complex par,.h.,i ng .dot, nathen than proceeding euteitty acno.6.6 the .inteAuection. Would you ptea6e %ev.iew the actuation and con6iAm .i& you aaggree that a va tey guttex a Bong 57th Avenue would coAxec t the zituation? 16 you agree that th" woutd hotve the pro- btem, would you ptea.6e take the nece6.6any 6tep.6 to enbure that the wv,%k i6 compteted? 16 you have any questions negandi,ng th,ia, pteabe contact me at 571-3450, Ext. 158. TAC/gAz S.incenety, CITY OF FRIDLEY Thorn" A. CotbeAt, P.E. M siatant City EngineeA of Fridley AT THE TOP OF THE TWINS SUBJECT BUILDING PERM fi , r?1247 rpCity iECEIPT COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 I � CITY HALL FRIDLEY 55432 612-580-3450 NO. NUMBER 910-F15 REV. DATE 4/3/74 PAGE OF APPROVED BY JOB ADDRESS 1 LEGAL DESCR. LOTIV05 tt 7]7KCity TRACTOR ADDITION View SEE ATTACHED SHEET 2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE Dr. Irving Herman 2605 Natchez South St. Louis Park 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. SAME 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION Lj REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK epair fire damage 9 CHANGE OF USE FROM TO STIPULATIONS SEPERATE PERMITS REQUIRED FOR WIRING, HEATING, PLUMBING AND SIGNS" SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION ZONING SO. FT. CU. FT. OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT VALUATION $3 OOO SURTAX $1.50 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $18.00 PLAN CHECK FEE TOTAL FEE $19:50 SIGNATURE OF CONTRACTOR ORAUTHORIZED AGENT (DATE)_VV HEN P 0 BLDG INSP RL ALI TED THIS IS YOUR PERMIT OATE SIGNATU RE OF OWN ER I IF ER BUILDER) IDATEI v APPLICATION FOR RLSIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF 1-RIDLLY, ti1INNESOTA OWNER I S NAME d�� �L ll% �0447 U ILDER : ADDRESS: CI 5' A 14. ADDRESS NO:. Z STREET: LOT: / `ff BLOCK: / ADDITION: � � �� % Q 6'v CORNER LOT INSIDE LOT: SETBACK: SIDEYARD: Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. T DESCRIPTION OF BUILDING To Be Used As: P// -7ZeFront : Depth: Height: Square Feet: Cubic Feet: Front: Depth: Height: Square Feet; Cubic Feet: Type of Construction: Estimated Cost: $ 3 To Be Completed: .3 0 �/ The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in stfict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that X11 the facts and representations stated in this application are true and �.;.,rr,-c t . 11 DATE: 31-7 SIGNATURE: ��" (See Reverse Side For Additional Information.) /f r� /9J_D SUBJECT of Fridley� FERCity 9 AT THE TOP OF THE TWINS BUILDING PERMIT f CEIPT . 41. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 04LI,®7 CITY HALL FRIDLEY 55432 NUMBER REV. BATE PAGE OF APPROVED BY L 612-571-3450 910-F/5 4/24/85 JOB ADDRESS 262 - 57th. Place N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 , 4,5 7 ity Vi,eW SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE David & Norma Rust 5735 Quincy Street N.E. 571-5735 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO, B USE OF BUILDING Apartment 7 CLASS OF WORK ❑ NEW ❑ ADDITION J] ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof Structure 9 CHANGEOFUSEFROM TO STIPULATIONS Roof can be the 2nd layer but not the 3rd. Install ridged galvanized valleys. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. Fiberglass THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 8 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $3,100 $1,55 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $44.50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $46.05 SIGNATURE OF CONTRACTOROR AUTHORIZED AGENT (DATE) N PR �X.L.. V LID D THIS IIS/YO�U^/R��PERMIT INSP DATE SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI Prepaid Plan Check $ Estimated Cost = Receipt # City Of Fridley R-3, COMMERCIAL A INDUSTRIAL Building Permit Application Construction Address: aha- s 7t4- —pl a c e /UL-- Effective 4/1/84 Legal Description:Z®/-, 3- v r;lack 7 mild Property Owner A Address:_ LDa v , a to G )dl,ai cL lL11 C ru q c�, /ISL -Tel. # 5 /i 5 23 Contractor A Address:_ Tel. Architect A Address: Reg.#_ Engineer b Address: Reg.# Type of Work [ ]New [ ] Addition APPLICANT SIGNATURE: [ )J Alteration reg of USE OF BUILDING: Tel. # _571-5 35 Date: 51-2,/- 9s BUILDING DIMENSIONS Size of Structure Length _ Width Height Sq. Ft. # of Stories OFC. AREA: Length Width Height Sq. Ft. WHSE. AREA: Length Width Height Sq. Ft. OTHER AREA: Length Width Height Sq. Ft. VALUATION Sq. Ft. % $ _ Cost/Sq. Ft. = Valuation $ ) Sq. Ft. % $ Cost/Sq. Ft. = Valuation $ ) _ $ �/p_ Sq. Ft. 8 $ Cost/Sq. Ft. = Valuation $ ) Total Type of Building Construction Air Conditioned [ ]Yes [ ]No Permit Fee $ 4 S� Plan Check $ State Surcharge $ SAC Charge $ Park Fee $ Sewer Main Charge $ Driveway Escrow $ TOTAL $ -5- STIPULATIONS: Occupancy Group Class. Zoning Fire Protection System [ ]Yes [ ]No. See Fee Schedule on Reverse Side In excess of Prepaid Plan Check -See Back Pg. $.50/#1,000 Valuation (See Sched. for > $1 mil) $425 per SAC Unit Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] suB.iEtT - P City of Fridley f 2 9 985 AT THE TOP OF THE TWINS BUILDING PERMIT r? RECEIP COMMUNITY DEVELOPMENT DIV. _ r � PROTECTIVE INSPECTION SEC. � NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 ,j 612-571-3450 91'0-F15 8/3/99 JOB ADDRESS 262 57th Place NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3.4,5 7 lCity View SHEET 2 PROPERTY OWNER MAIL ADORES$ ZIP PHONE Rost 5739 Quincy Ave N Fridley MN 3 CONTRACTOR Lodermeier MAIL ADDRESS ZIP PHONE LICENSE NO M. J. kadagmm Const. 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING 8 Unit Apartment 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION I REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof 8 Unit aTear-nff 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL. PLUMBING. HEATING. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $3496 WITH WHETHER SPECIFIEkp HER OR NOT, THE GRANTING OF A PERMIT $1.75 DOES NOT PR E GIV AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIO OF O E STATE OR LOCAL LAW REGULATING CON. $97.25 Fire R C O H F MANCE OF CONSTRUCTION C $3.50 PLAN CHECK FEE TOTAL E $1 .50 ' S NA R OFCON'RACTORORAUTMORIZEDAGENT IOATEI EN RO Bl 'ARO LIDATE IS IS}�.yilrR PERMIT �IAtE S-GNATURE OF OWNERoF OWNER BUILDER- 10ATEI Prepaid Plan Check $ Estimated Cost $ Receipt # Effective 5/10/99 CITY OF FRIDLEY R-3, COMMERCIAL & INDUSTRIAL BUILDING PERMIT APPLICATION Construction Address Legal Owner & Address �, jdrOC /0" OMRAC CR & ADDRESS l !d g�f4rll�F Architect Reg.# Engineer Tel# Tel# 7(79 3-Z, 7 Reg.# BUILDING CONSTRUCTION l _ TYPE OF WORK 11 -New [] Addition [] Alteration -Describe Tl� Ste, / r A i� . oi� -- OFC. AREA: Length Width Height Sq. Ft. WHSE AREA: Length Width Height Sq. Ft. OTTER AREA: Len Width Height Sq. Ft. Building Use Air Conditioning [] Yes [] No Performance Bond Amount $ Permit Fee Plan Check Fire Surcharge State Surcharge SAC Charge Erosion Control Park Fee Construction Type Occupancy Group Fire Protection Provided [] Yes [] No See Reverse for Schedule Received [] Yes [] No Spec. Assessments $ Driveway Escrow $ 70M 0 C ( SD See Fee Schedule on Reverse Side In Excess of Prepaid Amount - See Reverse Side .001 x Permit Valuation (1/10th %) $.50/$1,000 Valuation (See Sched. for > $1 Million) $1050 per SAC Unit (Plans to MKCC for determination) $450.00 Conservation Plan Review Fee Determined By Engineering Agreement Necessary [] Not Necessary [] feet x $13.50/foot ATTACH STIPULATIONS APPLICANT 1 `c1e Tel # (P)x,2a/ 7`r#Date VALUATION Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ ) _ $ Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ ) TOTAL VALUE Building Use Air Conditioning [] Yes [] No Performance Bond Amount $ Permit Fee Plan Check Fire Surcharge State Surcharge SAC Charge Erosion Control Park Fee Construction Type Occupancy Group Fire Protection Provided [] Yes [] No See Reverse for Schedule Received [] Yes [] No Spec. Assessments $ Driveway Escrow $ 70M 0 C ( SD See Fee Schedule on Reverse Side In Excess of Prepaid Amount - See Reverse Side .001 x Permit Valuation (1/10th %) $.50/$1,000 Valuation (See Sched. for > $1 Million) $1050 per SAC Unit (Plans to MKCC for determination) $450.00 Conservation Plan Review Fee Determined By Engineering Agreement Necessary [] Not Necessary [] feet x $13.50/foot ATTACH STIPULATIONS Building PLUMBING Permit No.: c Inspections COMMERCIAL APPLICATION Received By: 763-572-3604 D 9�'�U L 2 9 CITY OF FRIDLEY 763-502-4977 FAX EFFECTIVE 1-1-09 DATE e; C,% YOUR E-MAIL ADDRESS 0--l"O-e-do a 1n5dy • Cb W1 SITE ADDRESS 96 TENANT SUITE NO. PROPERTY NAME: OWNER/ TENANT ADDRESS: CITY STATE ZIP PHONE: CONTRACTOR NAME:,A,,:7,u,-,4 F4v 1-,,. SSIVI.a'S SUBMIT A COPY OF YOUR STATE STATE LICENSE # D (S 9GLl pfo EXP DATE /Z Al © 9 LICENSE, BOND AND PLUMBING BOND # Y�d-3S 3 98 EXP DATE CERTIFICATE OF ADDRESS: /S7yY Qv�,��� ST ✓V_1� CITY W4,- STATE H.,'ZIP STS Y INSURANCE PHONE 786-zeszZ FAX -7G3- q32 -697y PERMIT TYPE 0 INSTITUTIONAL ULTI-FAMILY 0 SWIMMING POOL 0 TOWNHOUSE ACOMMERCIAIJINDUSTRIAL 0 OTHER TYPE OF WORK: 0 NEW OIREPLACEMENT 0 ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK gyface 73 I e�qs /t1•w,u:0/Aes,-c. 424 A �a�4c— L���` New I XTUI53 \4AYAi1�A AlF , _ CLOTHES WASHER _ FLOOR DRAINS _ RPZ VALVE _ URINAL DISHWASHER _ GAS PIPING BACKFLOW PREY. WATER HEATER _ DRINKING FOUNTAIN _ GREASE TRAP _ ROOF DRAINS _ WATER METER FAUCET _ KITCHEN SINK _ SHOWER _ WATER PIPING —FLAMMABLE WASTE TANK _ LAUNDRY TRAY _ SLOP SINK _ WATER SOFTENER _ LAVATORY _ SWIMMING POOL _ WATER CLOSET oz I Total Job $ ,oy All fees are based on valuation, including the cost of labor and materials. Valuation �r--- Permit Fee $ (1.25% of Job Valuation / Minimum fee: $35) Surcharge $ Valuation X .0005 Total Due $ Make Checks Payable to: City of Fridley THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a plumbing permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. NAME OF APPLICANT 5254-+1-' f'S " DATE O g SIGNATURE OF APPLICANT >ASETb1�* aSRF'l,i�l;T�`$UL1IC1�+13C'C%AECINf'stj r City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 I05� Building BUILDING Permit No?boq tcl 'c" inspections COMMERCIAL/INDUSTRIAL Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd. 763-502-4977 FAX EFFECTIVE 1-I-09 DATE YOUR MAID,ADDRESS - r SITE ADDRESS r' _j TENANT Suite No. PROPERTY OWNER NAME 9 � ADDRESS: CITY STATE ZIP PHONE: � .� :,, .•��� - ;. _ — ARCHITECT NAME: ADDRESS: CITY STATE ZIP CONTRACTOR NAME fP r' *NOTE:CITY LICENSE REQUIRED ADDRESS: - CITY .` STATE '..,/ ZIP COMMERCIAL, INDUSTRIAL AND PHONE: / ,'��:' = FAX MULTI FAMILY PROPERTY TYPE ❑TOWNHOUSE ❑COMMERCIAL/INDUSTRIAL ❑ INSTITUTIONAL El MULTI-FAMILY PERMIT TYPE ❑ADDITION ❑NEW CONSTRUCTION 0 OTHER ❑REMODEL ❑ROOF ❑ SWIMMING POOL PLEASE SUBMIT: 1.4 SETS OF DRAWINGS 5. CONTRACTORS LICENSE OR 6. SPECIAL INSPECTION 2. SURVEY/SITE PLAN LICENSE APPLICATION SCHEDULE 3.LANDSCAPE PLANS 7. PERFORMANCE BOND 4.ENERGY CALCS AMOUNT$ BUILDING TO BE USED AS: OFFICE sF WHS SF OTHER SF TOTAL SIZE: STORIES FIRE PROTECTION(Y/N) AC(Y/N) DETAILED DESCRIPTION OF WORK a 47, i�y, - THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. SIGNATURE OF APPLICANTPRINT NAME L)tt /sya f,L ` E f1l''eIDATE ALL FEES ARE BASED ON VALUATION Sq. ft. X$ Cost/sq. ft.=Valuation$ Sq. ft. x$ Cost/sq. ft.=Valuation$ Sq. ft. X$ Cost/sq. ft.=Valuation$ TOTAL JOB VALUATION: $ fin I" USE OCCUPANCY TYPE Permit Fee $ ,a j See Back Page for Fee Schedule Plan Review $ 65%of Building Permit Fee Fire Surcharge $. .001 times the total job valuation Surcharge $ ,� .0005 x Permit Valuation Minimum$.50 SAC Charge $ $2000 per SAC Unit(Plans to MWCC for determination) Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Special Assessments $ Agreement necessary( ) Non Necessary( ) Total Due $ Make checks palable to: Ci of Fridley Attach Stipulations x .: . . .. . . z� r vs' Y REVIEWED F OD � P A n BLDG I SPe for Y